HomeMy WebLinkAboutAPPLICATION MECHANICAL - 16-00527 - 1 Stationery Pl - Artco HVAC additionC I TY OF
REXBURG
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Am rim's Family community
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BUILDING APPLICATION
Mechanical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: Permit Type; ❑New ❑Remodel ❑Addition ❑BasementFmish'
Fees Paid: -❑ Yes ❑ No
1. Property Owner
Name: Artco /Taylor Corporation
Address: One Stationery Place City: Rexburg
tY State: Idaho Zip Code: 83441
Phone & Type: 208.359.1000 ❑ Office ❑ Mobile Email: irdevos@taylorcorp.com
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are you a homeowner doing work on your own home? ❑ Yes (Skip to #3 and complete the Homeowner's Exemption page)
❑ No: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any contractors/sub-contractors involved will need to submit their awn signed applications.
2. Mechanical Contractor
Name: Lewis Corporation
Registration #: HVC-C-4440 Ex 5-31-19
Address: 15136 W Hunziker Rd Pocatello p..
City: State: ldaho Zip Code: 83202
Phone &Type: zo8.z38.1zo2 O Office ❑ Mobile Email:
Contact/Rep. Name: Kenyan Lewis Phone: 208.238.1202 ,e2tyan@Icorp.corn
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Mechanical Contractor Authorized Signature: �a Date:7-21-16
3. Project Description
Address: Artco 1 stationery place OR- Lot #: _ Block #: _ Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: ❑ New Construction* ❑ Remodel ElAddition ❑ Basement Finish
Description Of work: HVAC Humidifiers
New Commercial Work: Contracted amount. $ 6775.00 Calculated Fee (See Below): $195.50
El Up to $10,000 = (total cost of system x.02) + $60 ❑ $10,0014100,000 = ((total cost of system -10,000) x.01) + $260
❑ Over $100,001= ((total cost of system -100,000) x.005) + $1,160
New Single -Family Residential Work: Sq. Ft.
❑ Up to 1,500 Sq. Ft = $130 ❑ 1,501-2,500 Sq. Ft = $195 ❑ 2,501-3,500 Sq. Ft = $260 ❑ 3,501-4,500 Sq. Ft = $325
❑ Over 4,500 Sq. Ft = $325+(65 x # of additional 1,000 Sq. Ft (or portion thereof)) $
New Multi -Family Residential: ❑ Duplex = $260 ❑ Three or more units = $((130 x # of buildings)+(65 x # of units))$_
New work on any other residence and Detached Shops: _ $(65 + (10 x # of HVAC fixtures))
Miscellaneous: ❑ Gas Pressure= $65 ❑ Furnace or A/C = $65 ❑ Water Heater = $65 ❑ Requested Inspection ---$65
❑ Gas Line = $65 ❑ Fireplace/Solid Fuel Burning Unit= $65 []Technical Service = $65/hour
❑ Plan Check =10% of Contracted Amount
Ar PuCAN T S SIGNATURE, CERT um.A iON AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the information herein
is correct and I swear that any information which may hereafter be given by mein hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg
shall be truthful and correct I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the
City to enter upon the above-mentioned property for Inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012
International Code in cases of any false statement or misrepresentation of fact in the application or on the pans on which the permit or approval was based. Permit void if not
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): Kenyan Lewis Sig ature: Date: 7-21-16
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AN will be scheduled for the next business day.
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Techmcian—(208)372.2341 Revised March, 2016